Individual
YESENIA RUBY IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
200 S MAIN ST, STE P1, POCATELLO, ID 83204-3261
(208) 244-6799
(208) 274-9407
Mailing address
200 S MAIN ST, STE P1, POCATELLO, ID 83204-3261
(208) 244-6799
(208) 274-9407
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-41488
ID
Other
Enumeration date
06/12/2014
Last updated
08/25/2025
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